Eyeworld

Innovative IOL technologies for the cataract surgeon are bothered by that. After a brief discussion, there are very few patients who will be bothered by dysphotop- sias from this lens, but it is a real thing and a real pos- sibility. I do think we need to make patients aware of it in terms of informed con- sent, but it is fixable. If they notice it with a +2.5 in their first eye, we can always im- plant a monofocal in their second eye. That will usu- ally give them pretty good quality distance vision for nighttime driving. Dr. Cibik: I have implanted 238 eyes with the ReSTOR +2.5, and I've only had one patient who had signifi- cant complaints of halo and glare, particularly with nighttime driving. I discuss this possibility with every patient who is considering implantation of a ReSTOR +2.5 lens. In my practice, I have not had many pa- tients complaining about severe halos or glare with the ReSTOR +2.5, and no one has ever required an explant. I think the hybrid optical design, which com- bines some of the best features of the Alcon mono- focal and multifocal IOLs, is the reason for a good visual disturbance profile, even in a multifocal lens. Dr. Lane: How are you targeting this lens for your patients? Tell me about the discussion that you have with your patients. Dr. Woodard: A recom- mendation from the doctor means a lot to a patient. My discussion starts with my preoperative counselor/ patient educator going into the room and discuss- ing the various options near vision is a potential for a drop-off in the quality of distance vision and glare and halos at night. If pa- tients are not comfortable with their nighttime driving or distance vision, I can't fix that. Problems with near vision can be overcome by wearing reading glasses and adding light. If patients want better quality distance vision that will come with some mid-range vision and some near vision, the +2.5 can be the best option. Not all, but most of my patients tell me that they function well at intermediate and at near with a +2.5. Dr. Cibik: Even physical stature can factor into pa- tient selection. Many taller patients with longer arms do well with the ReSTOR +2.5. Dr. Lane: Let's discuss visual disturbances in your experience with the +2.5. Dr. Tipperman: I used to show patients the videos and DVDs, but now I just have a short discussion and explain that some people see circles around lights at night when they drive with multifocal lenses. Many patients don't find it both- ersome, and in many pa- tients, it goes away; howev- er, a very small percentage of patients, and you can't predict this ahead of time, with this lens, and I have been surprised with the quality of near vision with the +2.5. I have found that they need to hold books a little farther away, but most people don't read small- print books anymore. Most people are reading tablets that they are holding a little farther away than tradition- al books. Dr. Lane: Additionally, most of those devices are backlit. As with all multifocal lens- es, lighting is the key. Dr. Tipperman: I tell pa- tients that I'd love to be able to give them a lens that will enable them to see well at all distances, but ev- erything is a trade-off, and the price paid for stronger my patients feel that their distance vision is not com- promised. This point needs to be highlighted when we are offering these lenses. As we all do, I ask my patients what they are willing to compromise and what they are not willing to compro- mise. Some will compro- mise reading but don't want to significantly compromise any distance clarity, so the +2.5 is the lens for them. If a patient says reading without glasses is most im- portant, then I will go with a +3.0. We know that no lens solves all issues. However, this is an additional lens option in our armamentari- um that allows us to better meet the needs of our pa- tients. I have been ecstatic Please refer to page 8 for impor tant product information about the Alcon products described in this supplement. " Some [patients] will compromise reading but don't want to significantly compromise any distance clarity, so the +2.5 is the lens for them. " –Lawrence Woodard, MD

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